CONCORD, N.H. — Radiology technician David Kwiatkowski was a few weeks into a temporary job at the University of Pittsburgh Medical Center-Presbyterian in 2008 when a co-worker accused him of lifting a syringe containing an addictive painkiller from an operating room and sticking it down his pants.

More syringes were found in his pockets and locker. A drug test showed he had fentanyl and other opiates in his system.

In what may be the scariest part of all, authorities say that when he swiped the fentanyl syringe, he left another one in its place, filled with a dummy fluid, ready to be used on a patient.

But Kwiatkowski did not go to jail. No one even called the police. Neither the hospital nor the medical staffing agency that placed him in the job informed the national accreditation organization for radiological technicians.

So just days after being fired, he was able to start a new job at a Baltimore hospital. And from there, he went from one hospital to another — 10 hospitals altogether in the four years after he was fired in Pittsburgh. All of them said they had no knowledge of his disciplinary history.

The potentially grave cost of those loopholes became clear only after Kwiatkowski’s arrest last month in New Hampshire, where he stands accused of infecting at least 31 Exeter Hospital patients with hepatitis C by stealing fentanyl syringes and replacing them with dirty ones tainted with his blood.

Now, thousands of hospital patients who may have crossed paths with Kwiatkowski in eight states — Arizona, Georgia, Kansas, Maryland, Michigan, New Hampshire, New York and Pennsylvania — are being tested to see if they, too, are infected with hepatitis C, a sometimes life-threatening virus that can destroy the liver and cause cancer.

As the Kwiatkowski case demonstrates, medical technicians aren’t as closely regulated as doctors or nurses, and there is no nationwide database of misconduct or disciplinary actions against them, the way there is for physicians.

“It seems that what happens in Pittsburgh stays in Pittsburgh,” said Barbara Yeninas, a spokeswoman for Springboard Healthcare Staffing and Search, one of at least seven medical staffing agencies that lined up jobs for Kwiatkowski. “They get hired, and they get fired, and they can move on to where- ver else they want.”

Kwiatkowski, 33, has pleaded not guilty to stealing drugs and tampering with needles in New Hampshire. He told investigators he was innocent and suggested that a co-worker had planted a fentanyl syringe found in his car.

“I’ve already said it. I did not take any drugs or do any drugs … and I’m gonna stick to that,” he said, according to the FBI account.

People involved in a 2010 incident at Arizona Heart Hospital tell a different story. Kwiatkowski was 10 days into a job assignment when a co-worker found him passed out in a bathroom stall. A stolen syringe, bearing a label for fentanyl, floated in the toilet. In the emergency room, he tested positive for both cocaine and marijuana.

This time police were summoned, but the officers decided not to file charges or even write up a report after being told that Kwiatkowski had flushed the syringe.

Hospital officials alerted Springboard, which had gotten Kwiatkowski the assignment in Arizona. Springboard also sent a report to the American Registry of Radiologic Technologists, the organization that 37 states rely on to verify that technicians have proper credentials.

But after learning police hadn’t filed charges, the national accreditation group dropped its inquiry without ever speaking to anyone in Arizona.

Colorado nurse infected 18

In 2010, surgical tech Kristen Diane Parker, who infected at least 18 Denver and Colorado Springs hospital patients with hepatitis C by stealing liquid painkillers and leaving behind her dirty syringes, was sentenced to 30 years in federal prison. She pleaded guilty in exchange for a 20 year prison sentence, but the judge threw that deal out, saying her actions had been “incomprehensible and unconscionable.”

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